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. 2010;32(1):38-46.
doi: 10.1159/000313883. Epub 2010 May 31.

Poverty and racial disparities in kidney disease: the REGARDS study

William M McClellan  1 , Britt B Newsome, Leslie A McClure, George Howard, Nataliya Volkova, Paul Audhya, David G Warnock
Affiliations

Poverty and racial disparities in kidney disease: the REGARDS study

William M McClellan et al. Am J Nephrol. 2010.

Abstract

There are pronounced disparities among black compared to white Americans for risk of end-stage renal disease. This study examines whether similar relationships exist between poverty and racial disparities in chronic kidney disease (CKD) prevalence.

Methods: We studied 22,538 participants in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study. We defined individual poverty as family income below USD 15,000 and a neighborhood as poor if 25% or more of the households were below the federal poverty level.

Results: As the estimated glomerular filtration rate (GFR) declined from 50-59 to 10-19 ml/min/ 1.73 m2, the black:white odds ratio (OR) for impaired kidney function increased from 0.74 (95% CI 0.66, 0.84) to 2.96 (95% CI 1.96, 5.57). Controlling for individual income below poverty, community poverty, demographic and comorbid characteristics attenuated the black:white prevalence to an OR of 0.65 (95% CI 0.57, 0.74) among individuals with a GFR of 59-50 ml/min/1.73 m2 and an OR of 2.21 (95% CI 1.25, 3.93) among individuals with a GFR between 10 and 19 ml/min/ 1.73 m2.

Conclusion: Household, but not community poverty, was independently associated with CKD and attenuated but did not fully account for differences in CKD prevalence between whites and blacks.

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Figures

Fig. 1
Fig. 1
Prevalence of REGARDS participants by race and level of GFR. The proportion of REGARDS subjects are denoted by bars, whites (□) and blacks (█), and the unadjusted black:white prevalence odds ratio is denoted by the triangles and line.
Fig. 2
Fig. 2
Proportion of REGARDS participants with household incomes below poverty by race and level of GFR. The proportion of whites (□) and blacks (█) and unadjusted black:white odds ratio.
Fig. 3
Fig. 3
Proportion of REGARDS participants living in high poverty communities by race and level of GFR. The proportion of whites (□) and blacks (█) and unadjusted black:white odds ratio.
See this image and copyright information in PMC

References

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